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Zhao W, Cui M, Zhang R, Shen X, Xiong X, Ji X, Tao L, Jia W, Pang L, Sun Z, Wang C, Zou H. IFITM1, CD10, SMA, and h-caldesmon as a helpful combination in differential diagnosis between endometrial stromal tumor and cellular leiomyoma. BMC Cancer 2021; 21:1047. [PMID: 34556086 PMCID: PMC8461929 DOI: 10.1186/s12885-021-08781-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/13/2021] [Indexed: 12/15/2022] Open
Abstract
Background The differential diagnosis of endometrial stromal tumor (EST) and uterine cellular leiomyoma (CL) remains a challenge in clinical practice, especially low grade endometrial stromal sarcoma (ESS) and CL, suggesting the need for novel immunomarkers panels for differential diagnosis. Interferon-induced transmembrane protein 1 (IFITM1) is a novel immunomarker for endometrial stromal cells, h-caldesmon is an immunomarker for smooth muscle cells and has a higher specificity than smooth muscle actin (SMA). So this study aimed to evaluate whether IFITM1, cluster of differentiation 10(CD10), SMA, and h-caldesmon are useful biomarker combinations for the differential diagnosis of EST and CL. Methods Tissue microarrays were used to detect IFITM1, CD10, SMA, and h-caldesmon immunohistochemical staining in 30 EST and 33 CL cases. Results The expressions of IFITM1 and CD10 were high in EST (86.7 and 63.3%, respectively) but low in CL (18.2 and 21.2%), whereas those of h-caldesmon and SMA were high in CL (87.9 and 100%) and low in EST (6.9 and 40%). In diagnosing EST, IFITM1 shows better sensitivity and specificity (86.7 and 81.8%, respectively) than CD10 (63.3 and 78.8%). The specificity of h-caldesmon in diagnosing CL was significantly higher (93.1%) than that of SMA (60%). When all four antibodies were combined for the differential diagnosis, the area-under-the-curve (AUC) predictive value was 0.995. The best combination for diagnosing EST was IFITM1 (+) or CD10 (+) and h-caldesmon (−) (sensitivity 86.7%, specificity 93.9%). Conclusion The best combination for diagnosing CL were h-caldesmon (+) and SMA (+) (sensitivity 87.9%, specificity 100%). IFITM1, CD10, SMA, and h-caldesmon are a good combination for the differential diagnosis of EST and CL.
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Affiliation(s)
- Weilin Zhao
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China.,Department of Pathology, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Mei Cui
- Department of Pathology, Xinjiang Uygur Autonomous Region People's Hospital, Xinjiang, 830001, China
| | - Ruiqi Zhang
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China
| | - Xihua Shen
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China
| | - Xin Xiong
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China
| | - Xinhua Ji
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China
| | - Lin Tao
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China
| | - Wei Jia
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China
| | - Lijuan Pang
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China
| | - Zhenzhu Sun
- Department of Pathology, Xinjiang Uygur Autonomous Region People's Hospital, Xinjiang, 830001, China
| | - Chun Wang
- Department of Pathology, Xinjiang Uygur Autonomous Region People's Hospital, Xinjiang, 830001, China.
| | - Hong Zou
- Department of Pathology, The First Affiliated Hospital, Shihezi University School of Medicine, Key Laboratory of Xinjiang Endemic and Ethnic Diseases of the Ministry of Education of China, NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Xinjiang, 832002, China. .,Department of Pathology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, 310009, China.
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Nasioudis D, Ko EM, Kolovos G, Vagios S, Kalliouris D, Giuntoli RL. Ovarian preservation for low-grade endometrial stromal sarcoma: a systematic review of the literature and meta-analysis. Int J Gynecol Cancer 2020; 29:126-132. [PMID: 30640694 DOI: 10.1136/ijgc-2018-000063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/15/2018] [Accepted: 10/26/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To evaluate the effect of ovarian preservation on oncologic outcomes for women with low-grade endometrial stromal sarcoma of the uterus. METHODS A systematic search of the Medline, Embase, Cohrane, and Web of Science databases was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies including patients with low-grade endometrial stromal sarcoma who had hysterectomy were identified. Data on tumor recurrence and death rate were pooled using a random effects model. RESULTS A total of 17 studies met the inclusion criteria and reported on 786 patients. Based on available information, ovarian preservation was noted in 190 patients while 501 had bilateral salpingo-oophorectomy. A significantly increased tumor recurrence rate was observed in the ovarian preservation group (89/190, 46.8%) compared with the bilateral salpingo-oophorectomy group (121/501, 24.2%) (OR 2.70, 95% CI 1.39 to 5.28). Based on data from 162 patients, no difference in death rate was noted between the ovarian preservation (2/34, 5.9%) and bilateral salpingo-oophorectomy (9/128, 7%) groups (OR 0.80, 95% CI 0.18 to 3.47). CONCLUSIONS Approximately one-quarter of patients with low-grade endometrial stromal sarcoma were managed with ovarian preservation. These women experienced a higher recurrence rate. Hormone exposure may be responsible for this elevated risk. Given the apparent high salvage rate, however, ovarian preservation may be an option only in a well-informed patient population.
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Affiliation(s)
- Dimitrios Nasioudis
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA .,Surgery Working Group, Obstetrics and Gynecology Subgroup, Society of Junior Doctors, Athens, Greece
| | - Emily M Ko
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Georgios Kolovos
- Surgery Working Group, Obstetrics and Gynecology Subgroup, Society of Junior Doctors, Athens, Greece
| | - Stylianos Vagios
- Surgery Working Group, Obstetrics and Gynecology Subgroup, Society of Junior Doctors, Athens, Greece
| | - Dimitrios Kalliouris
- Surgery Working Group, Obstetrics and Gynecology Subgroup, Society of Junior Doctors, Athens, Greece
| | - Robert L Giuntoli
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
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Iwasaki SI, Sudo T, Miwa M, Ukita M, Morimoto A, Tamada M, Ueno S, Wakahashi S, Yamaguchi S, Fujiwara K, Sakuma Y, Mikami Y, Nishimura R. Endometrial stromal sarcoma: clinicopathological and immunophenotypic study of 16 cases. Arch Gynecol Obstet 2013; 288:385-91. [DOI: 10.1007/s00404-013-2766-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Accepted: 02/12/2013] [Indexed: 01/09/2023]
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